Prognostic value of elastic lamina staining in patients with stage III colon cancer

Objective: The objectives of this study were to explore the feasibility of elastic lamina invasion (ELI) as a marker to evaluate the prognosis of stage III colon cancer patients. Methods: : A total of 105 consecutive patients underwent radical surgery (R0 resection) for stage III colon cancer at the Cancer Hospital of China Medical University from January 2015 to December 2017. Clinicopathological features, including radiological stage and elastic lamina staining, were analysed for prognostic significance in stage III colon cancer. Results: : A total of 105 patients with stage III colon cancer who met the criteria and had complete materials available were included. The median follow-up period of survivors was 41 months. During the follow-up period, 33 (31.4%) patients experienced recurrence after radical resection, and the 3-year disease-free survival (DFS) rate was 64.8%. The DFS rate of T3 ELI+ patients was significantly lower than that of T3 ELI- patients (P=0.000). The DFS rate of T3 ELI+ patients was significantly lower than that of pT4a patients (P=0.013). The DFS rate of T3 ELI- patients was significantly higher than that of pT4b patients (P=0.018). In the multivariate analysis, T3 ELI+ ([hazard ratio, HR], 8.444 [95% CI, 1.736-41.067]; P =0.008), N2 stage (HR,10.629[95% CI,3.858-29.286]; P<0.001), stage IIIC (HR, 0.136 [95% CI, 0.31-0.589]; P=0.008) and PNI (HR, 8.393 [95% CI, 2.094-33.637]; P=0.003) were independent risk factors for postoperative recurrence of stage III colon cancer. Conclusions: : Elastic lamina staining is expected to become a stratified indicator of recurrence risk for patients with stage III colon cancer and can guide individualized adjuvant chemotherapy, improving patient prognosis.